Treatment of ketoacidosis and diabetic coma by continuous intravenous administration of water, glucose, regular insulin and electrolytes.
The therapeutical scheme prescribed for the treatment of ketoacidosis and diabetic coma before the 1970s is quite stereotyped and inflexible in regard to the routes of administration and doses of insulin, as well as the management of dehydration and metabolic acidosis. This paper reports the experience of the Endocrinology Service of the General Hospital of the "La Raza" Medical Center for over 10 years. 35 patients with diabetic ketoacidosis were included in a treatment by continuous intravenous administration of glucose, water, insulin and potassium. These patients were programmed in a 12 hour study. The dose of insulin was estimated at a ratio of 1 IU per 1 gm of excess glucose over 2.0 gm/l. The amount of glucose administered was in ratio to the caloric requirements per kilo of bodyweight of the individual patient. The volume of water was administered on the basis of the degree of dehydration estimated. The potassium was prescribed at a ratio of 20 mEq/l of solution, or more if necessary. The patient's recovery was observed during a period of from 7 to 10 hours, with improvement of the hyperglycemia, dehydration and metabolic acidosis. The method has allowed us to observe the diabetic patient's rapid recovery when he has been in ketoacidosis or coma, without complications such as hypoglycemia. No mortality was observed.
D003926:Diabetic Coma / Q000628:therapy*; D016883:Diabetic Ketoacidosis / Q000628:therapy*; D005440:Fluid Therapy; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007263:Infusions, Parenteral; D007328:Insulin / Q000008:administration & dosage; D011188:Potassium / Q000008:administration & dosage; D014867:Water
D007328:Insulin; D014867:Water; D005947:Glucose; D011188:Potassium